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Rhinology and Facial Plastics
Published in Adnan Darr, Karan Jolly, Jameel Muzaffar, ENT Vivas, 2023
Adnan Darr, Karan Jolly, Shahzada Ahmed, Claire Hopkins
Internal maxillary artery ligation: Method used in failed cases of endoscopic sphenopalatine artery ligationDecongestion as per ESSWide MMAPosterior wall of maxillary sinus is removed with a drill/kerrison rongeurPosterior periosteum incisedInternal maxillary artery identified within pad of fat and ligated with clips
Anatomy of the head and neck
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
The upper part of the face and scalp is supplied by the terminal branches of the external carotid artery. The deep facial structures are supplied by the maxillary artery, which passes deep to the mandible. The superficial temporal artery passes upwards to supply the temporal region. The transverse facial artery is a branch of this artery that runs medially across the face, supplying the cheek structures. Small supraorbital and supratrochlear arteries, branches of the ophthalmic branch of the internal carotid artery, supply the forehead and anterior scalp.
Perioral Region
Published in Ali Pirayesh, Dario Bertossi, Izolda Heydenrych, Aesthetic Facial Anatomy Essentials for Injections, 2020
Krishan Mohan Kapoor, Philippe Kestemont, Jay Galvez, André Braz, John J. Martin, Dario Bertossi
The buccinator originates from the outer surfaces of the alveolar processes of the maxilla and mandible, respectively, opposite the molar teeth. Its fibers converge toward the modiolus. The buccinator presses the cheek against the teeth and gums during mastication and expels the distended cheek air between the lips (an activity important when playing wind instruments). The buccinator is supplied by branches of the facial and buccal arteries. The latter is a branch of the maxillary artery. Muscle innervation is via the buccal branch of the facial nerve.
Intra-arterial chemotherapy for rhabdomyosarcoma
Published in Pediatric Hematology and Oncology, 2021
Hunter R. Greer, Darren B. Orbach, Torunn I. Yock, Carlos Rodriguez-Galindo, Adam L. Green
In our patient, we aimed to exploit the advantages of IA chemotherapy by supplying a sufficient concentration of chemotherapy directly to the rhabdomyosarcoma tissue at its primary site. Though IA therapy decreases the likelihood of systemic side effects, our patient still experienced toxicity with neutropenia, mild rectal mucositis, and left ear tinnitus. Despite these adverse effects, the direct delivery of therapy to the tumor showed excellent initial results, with tumor necrosis and no sign of progression. However, the loss of the left internal maxillary artery necessitated stopping treatment. The mechanism of destruction of the left internal maxillary artery in our patient remains uncertain, though local endothelial toxicity from the intra-arterial infusion is the likeliest explanation. It is possible that the two courses of previous proton therapy contributed to this vessel toxicity, and so starting IA chemotherapy earlier in the course could have avoided this issue. In addition, reducing the IA therapy doses (especially cisplatin) would have had the potential to lessen systemic side effects and avoid toxicity to the vessel while maintaining antitumor effect. While it is possible that systemic cisplatin and doxorubicin would have had a similar tumor response, it is unlikely at this stage in the disease course; the high concentration allowed by IA delivery likely allowed the robust response seen.
Angiographic Findings in the Tolosa–Hunt Syndrome and Resolution after Corticosteroid Treatment
Published in Neuro-Ophthalmology, 2018
Krishnan Ravindran, Philip Schmalz, Nurhan Torun, Michael Ronthal, Yu-Ming Chang, Ajith J. Thomas
An MRI of the brain with and without contrast demonstrated inflammatory stranding and enhancement of the right orbital apex and perineural fat with extension into the lateral wall of the right cavernous sinus (Figure 1). A diagnostic cerebral angiogram was performed with injection into the right internal and external carotid arteries. The right external carotid injection demonstrated enlargement of the terminal branches of the right internal maxillary artery, the arteries of foramina rotundum and ovale, with no narrowing of the cavernous carotid. The distal terminus of these vessels gave rise to a hypervascular network within the lateral wall of the right cavernous sinus indicative of a vascular inflammatory process (Figure 2). This cavernous sinus lesion further received contribution from a branch of the accessory meningeal artery, through the foramen ovale. Notably, there was no evidence of early venous drainage to suggest a carotid-cavernous or other fistula. Additionally, a 3-mm aneurysm of the right meningohyophyseal trunk within the cavernous sinus was noted upon injection into the right internal carotid artery (Figure 3).
Bilateral suprazygomatic maxillary nerve block versus palatal block for cleft palate repair in children: A randomized controlled trial
Published in Egyptian Journal of Anaesthesia, 2018
Mohamed M. Abu Elyazed, Shaimaa F. Mostafa
With the exception of the middle meningeal nerve, maxillary nerve branches are located within the pterygopalatine fossa [11]. Blocking the maxillary nerve can achieve sensory blockade of both soft and hard palate [8]. Ultrasound-guided technique for maxillary nerve block allows direct visualization of the internal maxillary artery, proper needle positioning, and LA spread thus less risk of iatrogenic vessel or nerve damage [11]. In the suprazygomatic approach used in our study, the maxillary artery is situated inferior and ventral to the nerve and thus it is much safer than the infrazygomatic approach [11]. Moreover, the suprazygomatic approach avoids the risk of ocular injury previously reported with infrazygomatic and infraorbital blocks [14].